Prednisolone

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Generic Name: Prednisolone Brand Name(s): Generics only. No brands available.

Uses

What is Prednisolone used for?

Prednisolone is a man-made form of a natural substance (corticosteroid hormone) made by the adrenal gland. It is used to treat conditions such as arthritis, blood problems, immune system disorders, skin and eye conditions, breathing problems, cancer, and severe allergies. It decreases your immune system’s response to various diseases to reduce symptoms such as pain, swelling and allergic-type reactions.

How should I take Prednisolone?

Take this medication by mouth, with food or milk to prevent stomach upset, exactly as directed by your doctor. Carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.

There are many brands, strengths, and forms of liquid prednisolone available. Read the dosing instructions carefully for each product because the amount of prednisolone may be different between products. See also Precautions and Storage sections.

Follow the dosing schedule carefully. The dosage and length of treatment are based on your medical condition and response to treatment. Your doctor may direct you to take prednisolone 1 to 4 times a day or take a single dose every other day. It may help to mark your calendar with reminders.

Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Your dose may need to be gradually decreased.

If you have used prednisolone regularly for a long time or in high doses, you may have withdrawal symptoms if the drug is suddenly stopped. To prevent withdrawal symptoms (such as weakness, weight loss, nausea, muscle pain, headache, tiredness, dizziness), your doctor may reduce your dose gradually. Consult your doctor or pharmacist for more details, and report any withdrawal reactions right away.

Tell your doctor if your condition persists or worsens.

How do I store Prednisolone?

Prednisolone is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Prednisolone in the bathroom or the freezer. There may be different brands of Prednisolone that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Prednisolone down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Prednisolone?

Before taking prednisolone, tell your doctor or pharmacist if you are allergic to it; or to prednisone; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: eye disease (such as cataracts, glaucoma), heart problems (such as heart failure, recent heart attack), high blood pressure, liver disease, kidney disease, thyroid problems, diabetes, stomach/intestinal problems (such as diverticulitis, ulcer), brittle bones (osteoporosis), current/past infections (such as tuberculosis, positive tuberculosis test, herpes, fungal), bleeding problems, blood clots, certain mental/mood conditions (such as psychosis, anxiety, depression), low salts in the blood (such as low potassium or calcium), seizures.

This drug may make you dizzy. Alcohol or marijuana can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana.

This medicine may cause stomach bleeding. Daily use of alcohol while using this medicine may increase your risk for stomach bleeding. Limit alcoholic beverages. Consult your doctor or pharmacist for more information.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

This product may contain alcohol, sugar, and/or aspartame. Caution is advised if you have diabetes, alcohol dependence, liver disease, phenylketonuria (PKU), or any other condition that requires you to limit/avoid these substances in your diet. Ask your doctor or pharmacist about using this product safely.

Using corticosteroid medications for a long time can make it more difficult for your body to respond to physical stress. Therefore, before having surgery or emergency treatment, or if you get a serious illness/injury, tell your doctor or dentist that you are using this medication or have used this medication within the past 12 months. Tell your doctor right away if you develop unusual/extreme tiredness or weight loss. If you will be using this medication for a long time, carry a warning card or medical ID bracelet that identifies your use of this medication.

This medication may mask signs of infection. It can make you more likely to get infections or may worsen any current infections. Therefore, wash your hands well to prevent the spread of infection. Avoid contact with people who have infections that may spread to others (such as chickenpox, measles, flu). Consult your doctor if you have been exposed to an infection or for more details.

Prednisolone may cause vaccines not to work as well. Therefore, do not have any immunizations/vaccinations while using this medication without the consent of your doctor. Avoid contact with people who have recently received live vaccines (such as flu vaccine inhaled through the nose).

This medication may slow down a child’s growth if used for a long time. Consult the doctor or pharmacist for more details. See the doctor regularly so your child’s height and growth can be checked.

Older adults may be more sensitive to the effects of this drug, especially stomach bleeding.

During pregnancy, prednisolone should be used only when clearly needed. It may rarely harm an unborn baby. Discuss the risks and benefits with your doctor. Infants born to mothers who have been using this medication for an extended period of time may have hormone problems. Tell your doctor right away if you notice symptoms such as persistent nausea/vomiting, severe diarrhea, or weakness in your newborn.

This medication passes into breast milk. However, this drug is unlikely to harm a nursing infant. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Prednisolone during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Prednisolone. Prednisolone is pregnancy risk category C according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Prednisolone?

Nausea, heartburn, headache, dizziness, menstrual period changes, trouble sleeping, increased sweating, or acne may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Because this drug works by weakening the immune system, it may lower your ability to fight infections. This may make you more likely to get a serious (rarely fatal) infection or make any infection you have worse. Tell your doctor right away if you have any signs of infection (such as cough, sore throat, fever, chills). Use of this medication for prolonged or repeated periods may result in oral thrush or a yeast infection. Contact your doctor if you notice white patches in your mouth or a change in vaginal discharge.

This medication may rarely make your blood sugar rise, which can cause or worsen diabetes. Tell your doctor right away if you have symptoms of high blood sugar such as increased thirst/urination. If you already have diabetes, check your blood sugar regularly as directed and share the results with your doctor. Your doctor may need to adjust your diabetes medication, exercise program, or diet.

Tell your doctor right away if any of these unlikely but serious side effects occur: unusual tiredness, swelling ankles/feet, unusual weight gain, vision problems, easy bruising/bleeding, puffy face, unusual hair growth, mental/mood changes (such as depression, mood swings, agitation), muscle weakness/pain, thinning skin, slow wound healing, bone pain.

This drug may rarely cause serious (rarely fatal) bleeding from the stomach or intestines. If you notice any of the following unlikely but serious side effects, consult your doctor right away: black/bloody stools, vomit that looks like coffee grounds, persistent stomach/abdominal pain.

Seek immediate medical attention if any of these rare but serious side effects occur: chest pain, seizures.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Prednisolone?

Some products that may interact with this drug include: aldesleukin, other drugs that weaken the immune system (such as azathioprine, cyclosporine, cancer chemotherapy), mifepristone, drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, “blood thinners” such as dabigatran/warfarin, NSAIDs such as aspirin/celecoxib/ibuprofen).

Other medications can affect the removal of prednisolone from your body, which may affect how prednisolone works. Examples include estrogens, azole antifungals (such as itraconazole), rifamycins (such as rifabutin), St. John’s wort, drugs used to treat seizures (such as phenytoin), among others.

If your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually at dosages of 81-325 milligrams a day), you should continue taking it unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.

This product may interfere with certain lab tests (such as skin tests). Make sure laboratory personnel and all your doctors know you use this drug.

Prednisolone may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Prednisolone?

Prednisolone may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Prednisolone?

Prednisolone may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Prednisolone.

What is the dose of Prednisolone for an adult?

Usual Adult Dose for Multiple Sclerosis

Initial dose: 200 mg orally once a day for 1 week, then 80 mg orally every other day for 1 month

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Controlled clinical trials have shown corticosteroids to be effective in speeding the resolution of acute exacerbations of multiple sclerosis, although they have not been shown to affect the natural history of the disease.

Use: For the treatment of acute exacerbations of multiple sclerosis.

Usual Adult Dose for Allergic Reaction

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Ankylosing Spondylitis

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Aspiration Pneumonia

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Bursitis

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Dermatitis Herpetiformis

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Hypercalcemia of Malignancy

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Idiopathic (Immune) Thrombocytopenic Purpura

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Loeffler’s Syndrome

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Osteoarthritis

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Polymyositis/Dermatomyositis

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Psoriasis

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Rheumatoid Arthritis

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Sarcoidosis

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Seborrheic Dermatitis

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Systemic Lupus Erythematosus

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Ulcerative Colitis – Active

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Uveitis

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Iritis

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Optic Neuritis

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Gouty Arthritis

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Hemolytic Anemia

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Anti-inflammatory

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Immunosuppression

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Neoplastic Diseases

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Rheumatic Heart Disease

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Adrenocortical Insufficiency

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Corneal Ulcers

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Keratitis

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Pemphigus

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Mycosis Fungoides

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Psoriatic Arthritis

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Epicondylitis

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Iridocyclitis

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Chorioretinitis

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Choroiditis

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Berylliosis

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Synovitis

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Thrombocythemia

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Stevens-Johnson Syndrome

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Serum Sickness

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Erythema Multiforme

Dosing should be individualized based on disease and patient response:

Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Adult Dose for Nephrotic Syndrome

Initial episode: 1 mg/kg (up to 80 mg/day) orally once a day or 2 mg/kg (up to 120 mg) orally once every other day

Duration of therapy: 4 to 16 weeks

Comments:

-Once remission is achieved, taper slowly (up to 6 months).

-For infrequent relapse, the same initial dose and duration outlined above may be used.

Use: Recommended for use in adults with minimal-change nephrotic syndrome by the KDIGO (Kidney Disease: Improving Global Outcome) glomerulonephritis work group.

Usual Adult Dose for Asthma – Acute

Short-course “burst” therapy: 40 to 80 mg orally once a day or in 2 divided doses until peak expiratory flow (PEF) reaches 70% of predicted or personal best

For OUTPATIENT “burst” therapy: 40 to 60 mg orally once a day or in 2 divided doses for a total of 5 to 10 days

Comments:

-The National Heart, Lung and Blood Institute (NHLBI) guidelines for the management of asthma recommend short courses of oral systemic corticosteroids to gain prompt control when initiating long-term therapy.

-Burst therapy should continue until symptoms resolve and the peak expiratory flow (PEF) is at least 70% of predicted or personal best; this is generally 3 to 10 days, but may be longer.

-Long-term use of oral systemic corticosteroids should be reserved for the most severe, difficult to control cases due to well documented risk for side effects.

Use: Recommended for the treatment of acute episodes of asthma by the NHLBI National Heart, Lung and Blood Institute.

Usual Adult Dose for Asthma – Maintenance

7.5 to 60 mg orally once a day or every other day

Comments:

-Titrate dose to the lowest dose needed for control

-Long-term use of oral systemic corticosteroids should be reserved for the most severe, difficult to control cases due to well documented risk for side effects.

-Administer single dose in the morning or on alternate days in the morning; alternate-day therapy may produce less adrenal suppression.

Use: Recommended for long-term treatment of severe persistent asthma by the NHLBI National Heart, Lung and Blood Institute.

Renal Dose Adjustments

Use with caution

Liver Dose Adjustments

Use with caution; patients with cirrhosis may experience enhanced corticosteroid effect due to decreased metabolism

Dose Adjustments

Elderly: Dose selection should be cautious generally starting at the low end of the dose range.

Drug Discontinuation:

-Abrupt discontinuation after high-dose or long-term therapy should be avoided.

-Drug-induced adrenocortical insufficiency may persist for up to 12 months after drug discontinuation.

Recommendations:

-Gradual dose reduction is recommended when doses in excess of physiologic doses (7.5 mg orally or equivalent) are given for longer than 3 weeks.

-In situations of stress, restarting or increasing corticosteroid dose may be needed to account for drug-induced adrenocortical insufficiency.

Alternate Day Therapy:

-Alternate day therapy may be considered for long term oral glucocorticoid therapy to help minimize adrenal suppression, and other glucocorticoid-related side effects.

-In the event of an acute flare-up, a return to the full suppressive daily dose may be necessary; once stabilized, alternate day therapy may be reinstituted.

Dose adjustments of antidiabetic agents may be necessary while receiving corticosteroids.

Changes in thyroid status may require corticosteroid dose adjustment

Immunizations:

-Patients receiving immunosuppressive doses of corticosteroids should not receive live or live attenuated vaccines.

-Patients on immunosuppressive doses of corticosteroids may receive killed or inactivated vaccines, however their response to vaccination may be diminished and difficult to predict; routine administration of vaccines or toxoids should be deferred until corticosteroid therapy is discontinued if possible.

-Immunizations may be given in patients receiving corticosteroids as replacement therapy (e.g. for Addison’s disease)

Oral Corticosteroid Potency:

Prednisolone 5 mg is approximately equivalent to: Betamethasone 0.75 mg; Cortisone 25 mg; Dexamethasone 0.75 mg; Hydrocortisone 20 mg; Methylprednisolone 4 mg; Prednisone 5 mg; Triamcinolone 4 mg

Other Comments

Administration advice:

-Take orally, preferably with food or milk

Oral Disintegrating Tablets (ODT):

-Tablets should not be broken, if prescribed dose cannot be obtained a different formulation should be used

-Remove tablet from blister just prior to dosing

-Place ODT on tongue where it may be swallowed whole or allowed to dissolve in mouth, with or without water

Oral Solution and oral syrup:

-Use a suitable calibrated measuring device to assure proper dosing

Storage requirements:

-Protect from light and moisture

-Oral Disintegrating Tablets (ODT): Remove tablets from blister until just prior to dosing; the blister package should be peeled open; tablets are friable and not intended to be cut, split, or broken

-Oral Syrup: Do not refrigerate

-Oral Solution: Store at 39F to 77F (4C to 25C)

General:

-Current treatment guidelines may be consulted for more specific information on dose ranges.

-Hydrocortisone or cortisone are the first choice for treating primary or secondary adrenocortical insufficiency, however, synthetic corticosteroids may be used in conjunction with mineralocorticoids where applicable.

-Initial doses should be maintained or adjusted until a satisfactory response is achieved; this drug should be discontinued if there is a lack of response after a reasonable period of time and alternate therapy considered.

-Constant monitoring is necessary as dose adjustments may be needed due to changes in clinical status (e.g., remissions or exacerbations), in response to stressful situations not directly related to the disease being treated, toxicities, and varied individual responses to therapy.

Monitoring:

-Monitor growth velocity in pediatric patients

-Monitor intraocular pressure if therapy is continued for more than 6 weeks; regular eye exams should be encouraged

-Routine laboratory studies (including 2-hour postprandial blood glucose and serum potassium), blood pressure, weight, bone mineral density, and chest x-rays should be performed at regular intervals for patients on long-term therapy

-Consider obtaining upper gastrointestinal x-rays in patients with known or suspected peptic ulcer disease

-Monitor for hypothalamic-pituitary-adrenal (HPA) axis suppression, Cushing’s syndrome, and hyperglycemia with chronic use

-Consider monitoring renal function in elderly patients

Patient advice:

-Patients should understand that this drug is a corticosteroid and that it is important not to stop therapy abruptly.

-Patients should understand that during times of stress, such as surgery or infection, additional supplementation may be necessary; they should discuss with their healthcare professional whether they need to carry a medical identification card identifying their corticosteroid use.

-Patients on immunosuppressant doses of corticosteroids should understand that a greater risk of infection exists; they should avoid exposure to chickenpox or measles and if exposed, they should consult their healthcare professional promptly.

-Patients should check with their healthcare provider before starting any new medications, including herbal supplements and over the counter products, or receiving any vaccinations.

-Patients should be advised of common adverse reactions including fluid retention, changes in glucose tolerance, high blood pressure, behavioral/mood changes, increased appetite, and weight gain.

What is the dose of Prednisolone for a child?

Usual Pediatric Dose for Allergic Reaction

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Aspiration Pneumonia

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Bursitis

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenace dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Dermatitis Herpetiformis

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Hypercalcemia of Malignancy

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Loeffler’s Syndrome

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Osteoarthritis

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Polymyositis/Dermatomyositis

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Psoriasis

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Sarcoidosis

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Seborrheic Dermatitis

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Systemic Lupus Erythematosus

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Ulcerative Colitis – Active

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Uveitis

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Iritis

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Optic Neuritis

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Hemolytic Anemia

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Immunosuppression

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Neoplastic Diseases

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Adrenocortical Insufficiency

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Corneal Ulcers

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Keratitis

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Pemphigus

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Mycosis Fungoides

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Juvenile Rheumatoid Arthritis

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Psoriatic Arthritis

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Epicondylitis

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Iridocyclitis

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Choroiditis

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Synovitis

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Thrombocythemia

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Stevens-Johnson Syndrome

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Serum Sickness

Dosing should be individualized based on disease and patient response with less emphasis on strict adherence to age or body weight dosing:

Initial dose: 0.14 to 2 mg/kg/day OR 4 to 60 mg/m2/day OR 5 to 60 mg orally once a day or in divided doses 2 to 4 times a day

Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments:

-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.

-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

Usual Pediatric Dose for Asthma – Acute

Age: Less than 12 years:

Short-course “burst” therapy: 1 to 2 mg/kg orally in 2 divided doses until peak expiratory flow (PEF) is 70% of predicted or personal best

-Dose of 1 mg/kg/day appears to be equally efficacious and may result in fewer behavioral side effects

Maximum dose: 60 mg/day

Duration of therapy: 3 to 10 days

Age: 12 years or older:

Short-course “burst” therapy: 40 to 80 mg orally once a day or in 2 divided doses until PEF is 70% of predicted or personal best

-For OUTPATIENT “burst” therapy: 40 to 60 mg orally once a day or in 2 divided doses

Duration of therapy: 5 to 10 days

Comments:

-The National Heart, Lung and Blood Institute (NHLBI) guidelines for the management of asthma recommend short courses of oral systemic corticosteroids to gain prompt control when initiating long-term therapy.

-Short courses of oral corticosteroids should be considered at the first sign of infection in children who have a history of severe exacerbations with viral respiratory infections.

-Burst therapy should continue until symptoms resolve and the PEF is at least 70% of predicted or personal best; this is generally 3 to 10 days, but may be longer.

-Long-term use of oral systemic corticosteroids should be reserved for the most severe, difficult to control cases due to well documented risk for side effects.

Use: Recommended for treatment of acute episodes of asthma by the NHLBI National Heart, Lung and Blood Institute.

Usual Pediatric Dose for Nephrotic Syndrome

Age: 1 year or older:

Initial episode: 60 mg/m2 or 2 mg/kg (up to 60 mg/day) orally once a day for at least 4 to 6 weeks; follow with alternate-day therapy: 40 mg/m2 or 1.5 mg/kg (up to 40 mg/day) orally once a day on alternate days for 2 to 5 months with tapering of dose

Duration of therapy: At least 12 weeks

Infrequent Relapsing Episodes: 1 relapse in 6 months or 1 to 3 relapses in 12 months:

60 mg/m2 or 2 mg/kg (up to 60 mg/day) orally once a day until urinary protein is negative for 3 days; follow with alternate-day therapy: 40 mg/m2 or 1.5 mg/kg (up to 40 mg/day) orally once a day on alternate days for 4 weeks, then taper dose

Frequent Relapsing Episodes: 2 relapses in 6 months or 4 or more relapses in 12 months:

60 mg/m2 or 2 mg/kg (up to 60 mg/day) orally once a day until complete remission for at least 3 days, then 40 mg/m2 or 1.5 mg/kg (up to 40 mg/day) orally once a day on alternate days for at least 3 months

-For those who are frequent relapsers: The lowest dose (preferably every other day) to maintain remission without major adverse effects should be used; consider corticosteroid-sparing agents.

Comments:

-Studies have shown an initial steroid treatment period of 6 weeks followed by an alternate-day maintenance period of 6 weeks (total duration 12 weeks) has resulted in a lower rate of relapse.

-Daily prednisolone may need to be given during episodes of upper respiratory tract and other infections to reduce the risk for relapse in children with frequently relapsing steroid dependent nephrotic syndrome already on alternate-day therapy.

Use: Recommended for use in in children with steroid-sensitive nephrotic syndrome by the KDIGO (Kidney Disease: Improving Global Outcome) glomerulonephritis work group.

How is Prednisolone available?

Prednisolone is available in the following dosage forms and strengths:

  • Injectable suspension,
  • Injectable solution,
  • Oral syrup,
  • Oral tablet,
  • Oral liquid,
  • Oral tablet, disintegrating,
  • Compounding powder,
  • Oral suspension.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Prednisolone, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: April 21, 2018 | Last Modified: April 21, 2018

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